Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Aug 7, 2019
Date Accepted: Jan 26, 2020
British South Asian patients’ perspectives on a digital health brief messaging system to support medication adherence for type 2 diabetes: a qualitative study
ABSTRACT
Background:
The prevalence of type 2 diabetes is greater in South Asian populations and health outcomes are poorer. British South Asians are up to six times more likely to have type 2 diabetes than the general population, to develop the condition at a younger age, and to experience diabetes-related complications. Interventions to support people in effectively self-managing their condition can potentially reduce costly, debilitating complications. Evidence to support the use of digital devices, including mobile phones, in type 2 diabetes management has shown positive impacts on glycaemic control. There is increasing recognition that health interventions that are culturally adapted to the needs of specific groups are more likely to be relevant and acceptable, but evidence to support the effectiveness of adapted interventions is limited and inconclusive.
Objective:
This formative study aims to explore the perceptions and views of British South Asian patients with type 2 diabetes on a digital health brief messaging system to support medication adherence, aimed at the general UK population.
Methods:
Eight exploratory focus groups were conducted in Leicester, UK, between September 2017 and March 2018. A diverse sample of 67 adults took part.
Results:
British South Asian people with type 2 diabetes who use digital devices, including smartphones, felt that brief messages to support medication adherence would be acceptable and relevant, but they also wanted messages that would support other aspects of self-management too. Participants were particularly interested in content that met their information needs, some of which were ‘cultural’, such as information about South Asian foods, commonly used herbs and spices, and religious fasting. Brief messages delivered in English were perceived to be acceptable, often because family members could translate for those unable to read or understand the messages. Suggestions to support patients unable to understand brief messages in English included having them available in different formats, and disseminated in face-to-face groups for those who did not use digital devices.
Conclusions:
Exploring the views of British South Asian patients about a brief messaging system aimed at the general UK population is important in maximising the potential of such an intervention. For such a system to meet the needs of UK South Asian populations, it would also have to include culturally-relevant messages sent to those who opt to receive them. Future research should explore how best to co-design and test culturally adapted messages that could be incorporated into a general digital messaging system aimed at all UK patients with type 2 diabetes.
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